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General NPI Number Information
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NPI Number | 1053405613
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Entity Type | Individual
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Provider Name | ELEANOR ELIZABETH WRIGHT LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 1310 3RD ST SW STE 2
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City | ROANOKE
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State | VA
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Zip | 24016-5219
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Country | US
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Telephone | 540-815-7886
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Fax | 833-944-2522
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Provider Business Mailing Address
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Address Line | 1970 ROANOKE BOULEVARD
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City | SALEM
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State | VA
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Zip | 24153
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Country | US
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Telephone | 540-982-2463
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 090400458
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License Number State | VA
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